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the Evergreen <br />��r��F CONSTR�I�TION <br />evereit PERMI � <br />��,�.�,�� ,�,a�E, <br />1 vCNF tt,',;4511NI4t0': <br />9AP01 <br />°`°` °�E�'�,a�;;E„ BUILDING M�CHANICAL <br />OWNEF p1AILAU�RESS 21P <br />. "._ . .'".�. . .': . � . .. "r �.:. . .� . ' .''��J �:'ctfs <br />ARCHITECT OR DESIGNER MAILl�DDRE55 PHONE <br />GEN,EtRALCOIJTRACTpR MAILADD�lE.'iS PHGiJE <br />Ji�"�i <br />MECNANICALCONTRACTOR MA!LADC�ftE55 P�inni� <br />AD <br />PLUMBING <br />n.,n.. <br />.7.T f"y J'✓.� 0 <br />LICENSE ! <br />L <br />�f'0!�:LDING �PLUM6ING ❑MECHANICALI <br />�EW ❑ADDITION ❑ALTEqATION ❑qEPAIR <br />VALUATION OF O /Kyy — <br />S �����uy ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIfdhliNG PpOL <br />orscRiec woaK — <br />i��::'i:'.7��« :ixoC`p� ,. .. ,�. -..TT:'.���' <br />PFOPOSED USE <br />MECHANICAL <br />TVP[OFFUEL �OIL �Nl�T. �LPG. <br />FOUflL DESES IPTION OF PqOPERTV (SHpW BELOW OR ATTACH GAS <br />�07 � B�oCK—oF �'���� p�� NO. TYPE OF E�UIPMENT <br />J06 l�D�RE <br />PLUMBING <br />�IN <br />H[fl <br />ING PC <br />-SINK <br />TpACK <br />SPECIAL CONDITIONS: <br />nv <br />ETs !'�•t �-/'.tt : �� <br />T6ACK IRLAR <br />❑VES ❑NO <br />AIR ('f�ND. UNITS-H.P. EA. <br />REFHICERATION UNITS-H.P. EA <br />�OILERi-H.P.EA. <br />GAS �IPE� A.C. UNITS-TONNAG <br />FOPCED AIF. SYSTEMS--B.T.U. M <br />WAIL HEATEFS-B.T.U. M <br />UNIT HEATERS-B.T.U. M <br />EVAPOf�GTIVECCOLERS <br />RANGEHOOD <br />111R HANDLING UNIT- <br />INCWERATOR <br />everett <br />uz.-7f <br />� <br />W <br />m <br />� <br />� <br />z <br />� <br />� <br />� <br />W <br />a <br />7V� <br />TOTAL FEE SI I <br />THIS PEFMIT �ECOMES NULL AND VOID IF WOflK OR CONSTRUG <br />TION AUTHOPI2ED IS NOT COMLIENCED WITHIN 1'.0 �AVS, OR IF <br />CONSTFVCTION OR WORY, IS SU£;P[NDED Ofl ABANDONE� FUR A <br />PEFIOD OF 120 �AYS AT ANY'fIA1E AFTER WORK IS COMM�tNCED. <br />I HEREBV CEFTIFV THAT I NAVE PEHD �1ND EXAMWED THIS AP� <br />PLICATION ANO KNOW THE SAME TO dE TqUE AND CORRECT. ALl <br />PROVISIONS OF LAWS AND ORDINANCES GOVERfJING THIS TYPE <br />OF WOFK bVILL BE CUMPLIED WITH WHETH[R SPECII°IEO HEPCIN <br />OR NOT, THE GRANTING OP A P[RM111T DDES (vOT PflESUME TO <br />GIVE AUTHORITV TO VIOLATE OR Cl�NCEL THE PflOVI510N5 OF <br />AN� OTHER STATE OR LOCAL LAW REGULATING CONSTRl1CTION <br />ORTNEP[FFOflMANCEOFCONSTRUCTION. <br />x �" � <br />SIGNATUREOFCONTIiACTOFORAUTH.(\GENT DATE <br />PLAN CHECK NUM6ER '•PLAN CHECK fEE <br />'#� F E E ih.44 � q'6�y Jo. <br />fEES VALUATION FEE <br />oca�ono [�u��owr, 5 � �✓-'-`"^� s-'i"" <br />PLUM8ING I <br />�PHINKLERS I <br />IqED � <br />ES ❑NO MECHANICAL � <br />('THEft � <br />_ I <br />PENELTY SEC.3031a) I <br />�TOTAL $F�jL�� <br />PERMIT VALIDATION <br />WH[D! PROPERI.Y VALIDATED IIN THISSPACEI THIS IS VOl1F �LRMI f <br />C� <br />n <br />